Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$3,644.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$3,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$3,644.00
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

BLUE MAX BALLOON DIALTION

Facility

$813.00

Hospital Charge Code	270332340
Hospital Revenue Code	272
Min. Negotiated Rate	$23.09
Max. Negotiated Rate	$406.50
Rate for Payer: Aetna Commercial	$308.94
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.38
Rate for Payer: Oxford Commercial	$162.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.95
Rate for Payer: UnitedHealthcare Commercial	$162.60
Rate for Payer: UnitedHealthcare Community & State	$25.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.09

BLUE MAX BALLOON DIALTION

Facility

$813.00

Hospital Charge Code	270332340
Hospital Revenue Code	272
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

BLUE MAXI LOOPS

Facility

$15.00

Hospital Charge Code	270331579
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

BLUE MAXI LOOPS

Facility

$15.00

Hospital Charge Code	270331579
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

BLUNT 12MM STD THD ANCHOR

Facility

$695.52

Service Code	HCPCS C1713
Hospital Charge Code	270600096
Hospital Revenue Code	278
Min. Negotiated Rate	$104.33
Max. Negotiated Rate	$168.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.32
Rate for Payer: Qualcare PPO/HMO/WC	$104.33

BLUNT 12MM STD THD ANCHOR

Facility

$695.52

Service Code	HCPCS C1713
Hospital Charge Code	270600096
Hospital Revenue Code	278
Min. Negotiated Rate	$19.75
Max. Negotiated Rate	$347.76
Rate for Payer: Aetna Commercial	$264.30
Rate for Payer: Aetna Medicare Advantage	$208.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.36
Rate for Payer: Cigna Commercial	$347.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.32
Rate for Payer: Qualcare PPO/HMO/WC	$104.33
Rate for Payer: UnitedHealthcare Community & State	$21.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.75

BLUNT PIN 3.2MM

Facility

$265.00

Hospital Charge Code	270692840
Hospital Revenue Code	272
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

BLUNT PIN 3.2MM

Facility

$265.00

Hospital Charge Code	270692840
Hospital Revenue Code	272
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

BLUNTPORT

Facility

$611.00

Hospital Charge Code	270335150
Hospital Revenue Code	272
Min. Negotiated Rate	$91.65
Max. Negotiated Rate	$91.65
Rate for Payer: Qualcare PPO/HMO/WC	$91.65

BLUNTPORT

Facility

$611.00

Hospital Charge Code	270335150
Hospital Revenue Code	272
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$305.50
Rate for Payer: Aetna Commercial	$232.18
Rate for Payer: Aetna Medicare Advantage	$183.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.81
Rate for Payer: Cigna Commercial	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.86
Rate for Payer: Oxford Commercial	$122.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.65
Rate for Payer: UnitedHealthcare Commercial	$122.20
Rate for Payer: UnitedHealthcare Community & State	$19.31
Rate for Payer: Wellpoint Medicaid Managed Care	$17.35

BLUNT TROCAR 10MM

Facility

$128.00

Hospital Charge Code	270338716
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

BLUNT TROCAR 10MM

Facility

$128.00

Hospital Charge Code	270338716
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

BLUNT TROCAR & SYRINGE

Facility

$554.00

Hospital Charge Code	270332619
Hospital Revenue Code	272
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$83.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.10

BLUNT TROCAR & SYRINGE

Facility

$554.00

Hospital Charge Code	270332619
Hospital Revenue Code	272
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$277.00
Rate for Payer: Aetna Commercial	$210.52
Rate for Payer: Aetna Medicare Advantage	$166.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.27
Rate for Payer: Cigna Commercial	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Oxford Commercial	$110.80
Rate for Payer: Qualcare PPO/HMO/WC	$83.10
Rate for Payer: UnitedHealthcare Commercial	$110.80
Rate for Payer: UnitedHealthcare Community & State	$17.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.73

BMAC

Facility

$4,900.00

Hospital Charge Code	270686678
Hospital Revenue Code	272
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BMAC

Facility

$4,900.00

Hospital Charge Code	270686679
Hospital Revenue Code	272
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BMAC

Facility

$4,900.00

Hospital Charge Code	270686679
Hospital Revenue Code	272
Min. Negotiated Rate	$139.16
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,862.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,274.00
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$980.00
Rate for Payer: UnitedHealthcare Community & State	$154.84
Rate for Payer: Wellpoint Medicaid Managed Care	$139.16

BMAC

Facility

$4,900.00

Hospital Charge Code	270686678
Hospital Revenue Code	272
Min. Negotiated Rate	$139.16
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,862.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,274.00
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$980.00
Rate for Payer: UnitedHealthcare Community & State	$154.84
Rate for Payer: Wellpoint Medicaid Managed Care	$139.16

BME ELITE 5 X 15 X15

Facility

$6,822.35

Service Code	HCPCS C1713
Hospital Charge Code	270689663
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$3,411.18
Rate for Payer: Aetna Commercial	$2,592.49
Rate for Payer: Aetna Medicare Advantage	$2,046.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.70
Rate for Payer: Cigna Commercial	$3,411.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.35
Rate for Payer: UnitedHealthcare Community & State	$215.59
Rate for Payer: Wellpoint Medicaid Managed Care	$193.75

BME ELITE 5 X 15 X15

Facility

$6,822.35

Service Code	HCPCS C1713
Hospital Charge Code	270689663
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.35
Max. Negotiated Rate	$1,651.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.35

BMT 360 TIB AUG 67 X 10MM

Facility

$5,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270687530
Hospital Revenue Code	278
Min. Negotiated Rate	$161.03
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$179.17
Rate for Payer: Wellpoint Medicaid Managed Care	$161.03

Know your out-of-pocket cost for care.

All Charges